Comparação entre comissurotomia e valvoplastia por cateter-balão na estenose mitral: cinco anos de acompanhamento

OBJETIVO: Comparar dados clínicos-laboratoriais em portadores de estenose mitral submetidos à comissurotomia ou valvoplastia por cateter-balão, obtidos ao longo de 5 anos de acompanhamento. MÉTODOS: Foram acompanhados, prospectivamente, 81 pacientes no pré (PRÉ), imediatamente após o procedimento (POI), e ao longo de cinco anos (PO12M, PO24M,..., PO60M) e randomizados em dois grupos: GC: 37 pacientes (32,4 ± 7,2 anos e 89,2% mulheres) e GV: 44 pacientes (32,9 ± 9,5 anos e 90,9% mulheres). A avaliação compreendeu: classe funcional, ocorrência de eventos, eletrocardiograma e ecodopplercardiograma. RESULTADOS: Houve melhora expressiva da classe funcional na maioria dos pacientes, três casos do GC e do GV estavam em classe funcional III no PO60M. Não houve diferença em relação ao gradiente mitral entre os grupos. Houve diferença das médias de área valvar mitral entre os grupos durante toda avaliação. Não ocorreram óbitos. No POI do GC observamos 3 casos com insuficiência mitral (IM) moderada, 3 com sangramento (1 reoperado) e, no GV, 4 casos com IM moderada, 1 com IM importante, 2 com tamponamento cardíaco, 1 caso necessitou cirurgia por IM importante. Ao longo de 60 meses, no GV, 9 casos evoluiram com IM moderada ou importante e no GC, 6 casos evoluiram com IM moderada ou importante e outros dois necessitaram cirurgia por dupla disfunção mitral. CONCLUSÃO: Ambos os métodos obtiveram 100% de sucesso com baixa taxa de complicações. No seguimento, houve elevação discreta do gradiente mitral e queda de área valvar mitral em ambos os grupos.

O diagnóstico da obstrução da via de saída do ventrículo esquerdo na cardiomiopatia hipertrófica

A cardiomiopatia hipertrófica é uma doença genética prevalente caracterizada por hipertrofia ventricular esquerda, em que obstrução dinâmica da via de saída com geração de gradiente subaórtico incide em repouso em 30% dos casos. A obstrução é atribuida complexa interação entre o folheto anterior mitral, o septo interventricular e vetores anômalos de fluxo gerados no ventrículo esquerdo aliada a modificações na geometria da via de saída. Regurgitação mitral em grau variável é detectada associada ou não a deformidades estruturais do aparelho valvar. O ecocardiograma de esforço demonstra obstrução latente facilmente induzida por exercício em 60 a 75% das formas não obstrutivas. A determinação do gradiente nessas condições impõe-se na investigação de rotina dos pacientes com obstrução leve ou ausente em repouso. A avaliação da cardiomiopatia hipertrófica incorpora métodos de imagem baseados no ultrassom, os quais, adicionados ressonância magnética, possibilitam o reconhecimento de mecanismos geradores de obstrução ventricular, de modo a favorecer o diagnóstico e o manejo das formas obstrutivas e obstrutivas latentes.

Arritmias ventriculares e hipertrofia ventricular esquerda na cardiomiopatia hipertrófica

FUNDAMENTO: Na Cardiomiopatia Hipertrófica (CMH), o grau de Hipertrofia Ventricular Esquerda (HVE) poderia influenciar o desenvolvimento de arritmias ventriculares. OBJETIVO: Analisar, na CMH, a associação entre a ocorrência de arritmias ventriculares no eletrocardiograma-Holter (ECG-Holter) e o grau de HVE determinado ao ecocardiograma pela espessura parietal máxima (EPM) e Índice de Massa (IM). MÉTODOS: Cinquenta e quatro pacientes consecutivos com CMH realizaram ECG-Holter de 24 horas e ecocardiograma para avaliação do grau de HVE através da EPM e IM. Foram estabelecidos dois níveis para a ocorrência de arritmias ventriculares: I - extrassístoles isoladas ou pareadas e II - Taquicardia Ventricular Não Sustentada (TVNS). RESULTADOS: Nos 13 pacientes (24%) com TVNS (nível II), houve maior frequência de EPM do ventrículo esquerdo (VE) > 21 mm (n = 10, 77%; 25 ± 4 mm) e IMVE > 144 g/m² (n = 10, 77%; 200 ± 30 g/m²), em relação àqueles que apresentavam apenas arritmia extrassistólica (nível I) (n = 41, 76%), em que essas medidas foram identificadas em, respectivamente, 37% (n = 15, 23 ± 1 mm), p = 0,023, e 39% (n = 16, 192 ± 53 g/m²) dos casos, p = 0,026. Os citados valores de corte foram determinados por curva ROC com intervalo de confiança de 95%. O registro de TVNS foi mais comum em pacientes com EPMVE > 21 mm e IMVE > 144 g/m² (8 de 13; 62%), do que naqueles com uma (4 de 13; 31%) ou nenhuma (1 de 13; 8%) variável ecocardiográfica acima dos valores de corte, p = 0,04. CONCLUSÃO: A ocorrência de arritmias ventriculares no Holter associou-se, na CMH, ao grau de HVE, avaliado pelo ecocardiograma através da respectiva EPM e IM.

Descrição de seis espécies de Chinavia (Hemiptera, Pentatomidae, Pentatominae) da América do Sul

Seis novas espécies de Chinavia Orian, 1965 são descritas: Chinavia vanduzeei sp. nov., do Peru (Madre Dios) e Brasil (Pará); Chinavia schuhi sp. nov., do Peru (Loreto), Colombia (Bolívar) e Brazil (Amazonas); Chinavia sebastiaoi sp. nov., do Brazil (Mato Grosso do Sul), Bolivia (La Paz e Santa Cruz) e Paraguai (Carumbé); Chinavia cearensis sp. nov., Chinavia tuiucauna e Chinavia rufitibia sp. nov., do Brasil (Ceará, Bahia e Paraná, respectivamente). São fornecidas características diagnósticas de cada espécie.

Revisão do gênero neotropical Xeropigo (Araneae,Corinnidae, Corinninae)

O gênero Xeropigo O. Pickard-Cambridge, 1882 é revisado, com a proposição de sete novas espécies neotropicais: X. candango, sobre machos e fêmeas de Brasília, Distrito Federal e Goiás, Brasil; X. rheimsae, machos de Goiás, Brasil; X. camilae, sobre machos e fêmeas do norte e centro-oeste do Brasil; X. cotijuba, machos e fêmeas da Guiana e do norte e centro-oeste do Brasil; X. pachitea, machos e fêmeas de Huánuco e Cajamarca, Peru; X. perene, fêmeas de Junin e Loreto, Peru; X. brescoviti, machos de Beni, Bolívia. As espécies previamente conhecidas, X. tridentiger (Pickard-Cambridge, 1869), a espécie-tipo, descrita da Ilha de Santa Helena, Oceano Atlântico, mas também conhecida das Américas do Sul e Central, e X. smedigari (Caporiacco, 1955) do norte da Venezuela e Trinidad, são re-diagnosticadas. Novos registros, ilustrações de X. tridentiger e chave para todas as espécies conhecidas são fornecidos.

Analysis of phenotypes altered by temperature stress and hipermutability in Drosophila willistoni

Drosophila willistoni (Sturtevant, 1916) is a species of the willistoni group of Drosophila having wide distribution from the South of USA (Florida) and Mexico to the North of Argentina. It has been subject of many evolutionary studies within the group, due to its considerable ability to successfully occupy a wide range of environments and also because of its great genetic variability expressed by different markers. The D. willistoni 17A2 strain was collected in 1991 in the state of Rio Grande do Sul, Brazil (30°05'S, 51°39'W), and has been maintained since then at the Drosophila laboratory of UFRGS. Different to the other D. willistoni strains maintained in the laboratory, the 17A2 strain spontaneously produced mutant males white-like (white eyes) and sepia-like (brown eyes) in stocks held at 17°C. In order to discover if this strain is potentially hypermutable, we submitted it to temperature stress tests. Eighteen isofemale strains were used in our tests and, after the first generation, all the individuals produced in each strain were maintained at 29°C. Different phenotype alterations were observed in subsequent generations, similar to mutations already well characterized in D. melanogaster (white, sepia, blistered and curly). In addition, an uncommon phenotype alteration with an apparent fusion of the antennae was observed, but only in the isofemale line nº 31. This last alteration has not been previously described as a mutation in the D. melanogaster species. Our results indicate that the D. willistoni 17A2 strain is a candidate for hypermutability, which presents considerable cryptic genetic variability. Different factors may be operating for the formation of this effect, such as the mobilization of transposable elements, effect of inbreeding and alteration of the heat-shock proteins functions.

Lutzomyia (Trichophoromyia) pastazaensis, a new species of phlebotomine sand fly (Diptera: Psychodidae: Phlebotominae) from the Peruvian Amazon

The phlebotomine sand fly Lutzomyia pastazaensis n. sp. is described and illustrated from specimens collected from the edge of primary forest near Andoas, Department of Loreto, Peru (03º00'S, 76º05'W). This species appears to belong to the subgenus Trichophoromyia Barreto 1962, whose members are generally restricted to the Amazon Basin.

Species composition and seasonal abundance of sandflies (Diptera: Psychodidae: Phlebotominae) in coffee agroecosystems

The composition and seasonal occurrence of sandflies were investigated in coffee agroecosystems in the Soconusco region of Chiapas, Mexico. Insect sampling was performed on three plantations located at different altitudes: Finca Guadalupe Zajú [1,000 m above sea level (a.s.l.)], Finca Argovia (613 m a.s.l.) and Teotihuacán del Valle (429 m a.s.l.). Sandflies were sampled monthly from August 2007-July 2008 using three sampling methods: Shannon traps, CDC miniature light traps and Disney traps. Sampling was conducted for 3 h during three consecutive nights, beginning at sunset. A total of 4,387 sandflies were collected during the course of the study: 2,718 individuals in Finca Guadalupe Zajú, 605 in Finca Argovia and 1,064 in Teotihuacán del Valle. The Shannon traps captured 94.3% of the total sandflies, while the CDC light traps and Disney traps captured 4.9% and 0.8%, respectively. More females than males were collected at all sites. While the number of sandflies captured was positively correlated with temperature and relative humidity, a negative correlation was observed between sandfly numbers and rainfall. Five species of sandflies were captured: Lutzomyia cruciata , Lutzomyia texana , Lutzomyia ovallesi , Lutzomyia cratifer / undulata and Brumptomyia sp. Lu. cruciata , constituting 98.8% of the total, was the most abundant species. None of the captured sandflies was infected with Leishmaniaspp.

Supplemental nursing staff´s experiences at a Spanish hospital: Qualitative phenomenology research

The objective of this study was to describe the Supplemental Nursing Staff´s experiences at different hospital units. A qualitative phenomenological approach was conducted; a purposeful and theoretical sampling was implemented with supplemental nursing staff at Santa Barbara Hospital of Soria (Spain), to gain a more in-depth understanding of the Supplemental Nursing Staff ´s experience. Data were collected by in-depth interviews and through a field notebook. Data were analyzed using the Giorgi proposal. Twenty-one nurses with a mean age of 46 years were included. Three main topics emerged from the data analysis: building the first contact, carving out a niche and establishing interprofessional/interpersonal relationships. We conclude that the experience of hosting the supplemental nursing staff in changing clinical environments is conditioned by various factors. It is necessary for nurses and hospital managers to establish clear objectives with regard to the supplemental nursing staff´s role in the units.

Phylogenetic relationships among four species of the guarani group of Drosophila (Diptera, Drosophilidae) as inferred by molecular and morphological analyses

Traditionally, the Drosophila guarani species group has been divided into two subgroups: the guarani and the guaramunu subgroups. Two, out of the four species included in this research, are members of the guarani subgroup (D. ornatifrons Duda, 1927 and D. subbadia Paterson & Mainland, 1943) and two are included in the guaramunu subgroup (D. maculifrons Duda, 1927 and D. griseolineata Duda, 1927). However, some authors have suggested that D. maculifrons and D. griseolineata are much closer to some species of the Drosophila tripunctata group than to some of the species of the guarani group. To add new data to the matter under dispute, Polyacrylamide Gel Eletrophoresis (PAGE-SDS) was used for the analysis and comparison of protein composition and Random Amplified Polymorphic DNA (RAPD) analysis to find differences in genomic DNA, in addition to the analysis of quantitative morphological characters previously described. Analysis of PAGE-SDS results in a dendrogram that pointed out D. subbadia as being the most distant within the Drosophila guarani group. However, these results were not supported either by RAPD analysis or by the analysis of continuous morphological characters, which supplied the clustering of D. subbadia with D. ornatifrons. Although our data give strong support to the clustering of D. subbadia and D. ornatifrons, none of the dendrograms provided a clade comprising D. maculifrons and D. griseolineata. Thus, this research does not support the traditional subdivision of the D. guarani group into those two subgroups.

New species of the South American loxandrine genus Metoncidus Bates (Coleoptera, Carabidae)

Two species are added to the previously monotypic genus Metoncidus Bates, 1871 (Carabidae, Loxandrini): M. epiphytus sp. nov. (type locality Peru: Loreto, Cocha Shinguito) and M. gracilus sp. nov. (type locality Peru: Tambopata, Madre de Dios). Information allowing identification of the genus from among other South American carabid genera and a key to adult individuals of Metoncidus species are provided.

Color preference of Anastrepha obliqua (Diptera, Tephritidae)

The color preference of A. obliqua was evaluated in two-choice tests. The results showed that both sexes were attracted to wavelengths ranging from 340 nm to 670 nm, although the broad major peak of attraction occurred between 380 and 570 nm.

Description and life history of a new cecidogenous species of Palaeomystella Fletcher (Lepidoptera, Momphidae) from Brazil

ABSTRACTMale, female, pupa, and last-instar larva of Palaeomystella beckeri (Moreira and Basilio) a new species from the Atlantic forest, southern Brazil, are described and illustrated with the aid of optical and scanning electron microscopy. Larvae induce galls on apical branches of Tibouchina trichopoda (DC.) Baill. (Melastomataceae) within which pupation occurs. Gall description and preliminary data on life history are also provided.

Two new species of Mycodrosophila (Diptera, Drosophilidae) proposed by molecular and morphological approaches, with a key to American species

ABSTRACT There are approximately 130 species of MycodrosophilaOldenberg, 1914 worldwide, although only nine species were recorded in American countries so far, three of which are exclusively Nearctic, five exclusively Neotropical and one found in both biogeographic regions (Mycodrosophila projectans). Such a small number of American species is likely a consequence of collecting bias, which favors the capture of frugivorous drosophilids, and to the general absence of Neotropical Mycodrosophila studies in the last 50 years. Here, we describe two commonly sampled species of Mycodrosophila from the Amazonian and Pampa Brazilian biomes, which share morphological similarities with Mycodrosophila neoprojectans and M. projectans, respectively. We compared sequences of the mitochondrial gene cytochrome oxidase subunit I (COI), external morphology characteristics and male terminalia among these species. Based on a DNA barcoding approach coupled to morphological differences, we proposed the delimitation of two new species, Mycodrosophila hofmanni sp. nov. and Mycodrosophila valentae sp. nov. An updated key to identifying Neotropical and Nearctic Mycodrosophila species is also provided.

Modelos de demanda por manzanas frescas chilenas en países de la Unión Europea

Se usó la técnica de regresión de mínimos cuadrados ordinarios para estimar la demanda por importaciones de manzanas frescas exportadas por Chile en cinco países de la Unión Europea. Para las estimaciones se utilizaron observaciones anuales del periodo 1984 a 2003. Los resultados demuestran que (1) la demanda por importaciones de manzanas frescas chilenas depende de las tradicionales variables ingreso o gasto en consumo per cápita, (2) los precios relativos y la variación del tipo de cambio real juegan un papel destacado en la explicación de la demanda por importaciones, y (3) la demanda responde de manera diferente frente a los cambios en las variables explicativas en cada mercado.